Difficulty stopping urination or loss of control of bladder or bowels.

Unexplained fever, nausea or vomiting.

A history of cancer or unexplained weight loss.

No, I am not experiencing any of the above health issues.Yes, and I have not discussed these health issues with my doctor.Yes, I have one or more of these health issues but have been cleared by my doctor to proceed with this program.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Hearing Loss

Overview

Hearing loss is a common problem with many causes. It can be mild or severe, sudden or gradual, temporary or permanent. You can be born with hearing loss or it can occur as you get older. Age-related hearing loss eventually affects one-third of people by the time they turn 60, and more than half of those over the age of 85.

Symptoms

Losing your hearing can be a distressing and isolating problem, as you become less able to communicate with your family and friends. Sounds may seem distant or muffled, especially when there is background noise. If the hearing loss is gradual, a person with hearing loss is sometimes the last to know. Others may complain that the television is too loud, or that they have to repeat themselves too often. Additional symptoms that can be associated with hearing loss, depending on the cause, include the following:

Ringing in the ears (tinnitus)

Balance problems

Ear pain

Drainage or a plugged sensation

Types

There are 3 types of hearing loss:

Conductive hearing loss happens when sound is not transmitted to the inner ear because of a blockage caused most often by:

Ear infections

Wax build-up

Fluid build-up from colds and allergies

This type of hearing loss is usually temporary and sometimes can be treated with medicines or surgery.

Sensorineural hearing loss occurs when there is damage to the nerve pathways in the inner ear. Some common causes are:

Viruses

Loud noise exposure

Aging

This type of hearing loss is permanent, and a hearing aid can often help.

Mixed hearing loss means both the inner and outer ears are affected so you experience both conductive and sensorineural hearing loss at the same time.

Screening and Diagnosis

If you suspect you or a loved one has hearing loss, an audiogram test will help determine the severity and type of hearing loss. Sometimes the results of the audiogram can lead us to order another diagnostic test. We will discuss your options with you.

Causes and Prevention

To understand hearing loss, it helps to understand how the ear works. Sound travels through the ear canal and vibrates the eardrum. The eardrum is attached to 3 ossicles, the tiniest bones in your body, which help amplify the vibration in the middle ear. From there, the vibration travels to the cochlea in the inner ear, where the mechanical energy of sound is converted to electrical impulses. These impulses travel to the brain, which makes sense of these signals as the sound you hear.

With such a complicated system, you can imagine that many different things can go wrong. Sound can be blocked at the ear canal by earwax or infection. Sound can also be affected by a hole or fluid behind the eardrum that prevents vibration from getting to the inner ear. The ossicles can be affected by infection, skin growing from the eardrum (cholesteatoma), or bony overgrowth that causes the bones to "stick" (otosclerosis). The specialized inner ear cells in the cochlea can begin to lose function, often related to age or to noise exposure, and less commonly by exposure to infection or certain medications. Sometimes hearing loss can result from problems with the nerve that connects the cochlea to the brain. Your doctor can help you determine the cause of your hearing loss.

Illustration of the middle ear

Prevention

Limiting your exposure to loud noise is one thing you can do to prevent hearing loss. It is important to contact us if you suspect a problem. We can arrange a hearing test and appointments with specialists, as needed.

Please do not use Q-tips or cotton swabs to try to remove earwax in the ear. Q-tips can push earwax deeper into the ear canal and traumatize the eardrum.

Treatments

For conductive hearing loss:

Medications and surgery may be appropriate for conductive hearing loss related to problems with the ear canal, eardrum, middle ear and/or ossicles. Infections of the ear canal or middle ear respond to antibiotics. Holes in the eardrum, a skin cyst (cholesteatoma), or problems with the ossicles are usually surgical issues.

Hearing aids are a viable option for many people with conductive hearing loss. Bone-anchored hearing aids, which are physically attached to the skull, are also an option for a small group of people who can't wear a conventional hearing aid.

For sensorineural hearing loss:

Hearing aids and other assistive listening devices attached to the telephone or television can be helpful.

Medication is usually ineffective for this type of hearing loss. However, if your hearing loss occurs suddenly we might prescribe a medication and we will discuss this option with you, as appropriate.

Surgery in the form of a cochlear implant is available for those whose hearing loss is so severe that hearing aids can't help.

Illustration of the middle ear

Lifestyle Management

Hearing loss is not a hopeless situation. There are things you can do to continue to enjoy your favorite activities, remain independent, and feel safe. Here is a list of some helpful aids and devices:

Hearing aids can help you manage your hearing loss. It can take several weeks or months to get used to a new hearing aid because it amplifies all sounds, including background noise. You might find that it takes extra effort to have a conversation in situations where there is a lot of background noise, such as a family party, restaurant, airport or train station.

Assistive listening devices make certain sounds louder by bringing the sound directly to your ear and reducing background noise. You can use different types of devices for different situations. Some museums, theaters, and places of worship provide listening devices. Assisted listening devices include telephone amplifiers, personal listening systems and FM systems, as well as hearing aids that connect directly to a television, stereo, radio or microphone.

Alerting devices call attention to a particular sound like a doorbell, ringing telephone or baby monitor by transmitting louder sounds, lights, or vibrations to get your attention.

Speech reading is a listening technique that can help you adjust to hearing loss. It is different from lip-reading. You don't need to know how to lip read in order to successfully speech-read. When you speech-read you pay close attention to people's gestures, facial expressions, posture, and tone of voice. Reading these clues helps you understand what a person is saying and enhances your part of a conversation. Be sure to face the person you are talking to so you can see his or her face clearly.

Television closed-captioning displays the words at the bottom of your screen so that you can read instead of hear them. Most TVs have a built-in closed-caption option.

TTY/TTD is a newer technology that includes TTY (text telephone) and TDD (telecommunication). This device allows you to type messages back and forth on the telephone instead of talking or listening. When messages are typed on the TTY keyboard, the information is sent over the phone line to a receiving TTY and shown on a monitor. A telecommunications relay service (TRS) makes it possible to call from a phone to a TTY or vice versa.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.